Chronic necrotizing aspergillosis

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Chronic necrotizing aspergillosis (chronic necrotizing pulmonary aspergillosis, CNPA, semi-invasive or subacute invasive apergillosis) is infectious process pulmonary parenchyma developing in response to local invasion, usually A. fumigatus.

Clinical picture[edit | edit source]

It is a rare syndrome and, unlike IPA, CNPA develops slowly, from weeks to months and vascular invasion or dissemination to other organs usually does not occur. It can be difficult to distinguish from aspergillosis. However, CNPA is a local invasion of lung tissue, and a cavity filled with Aspergilus fungi may form secondarily as a result of fungal damage to the parenchyma. CNPA is characterized by necrosis of lung tissue, acute or chronic inflammation of the cavity wall, and the presence of hyphae.

Risk factors[edit | edit source]

It mainly affects older people with chronic lung diseases such as COPD, pulmonary TB, pneumoconiosis, cystic fibrosis, sarcoidosis, pulmonary infarction.

Symptomatics[edit | edit source]

Patients often complain of fever, malaise, fatigue, weight loss, chronic productive cough and hemoptysis. However, the course of CNPA can also be asymptomatic.

Diagnostics[edit | edit source]

A CT scan of the chest is used to diagnose CNPA, on which thickening of the pleura is visible, which can lead to the formation of a broncho-pleural fistula and a cavity lesion in the upper lung lobes. Serum IgG antibodies to A. fumigatus are also found in most patients. Again, histopathological examination and cultivation are necessary to confirm the diagnosis.

Treatment[edit | edit source]

Template:HVLP or Template:HVLPare most commonly used to treat mild to moderate forms of CNPA, with severe forms being treated with amphotericin BTemplate:HVLP and intravenous voriconazole.

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References[edit | edit source]

Kategorie:Vložené články Kategorie:Pneumologie Kategorie:Mikrobiologie Kategorie:Infekční lékařství